| Objective: To review the characteristics of TCM syndrome type distribution in patients with essential hypertension and carotid atherosclerosis,find the correlation between TCM syndrome type and neutrophil/lymphocyte ratio,carotid plaque area,ambulatory blood pressure or other physical and chemical indicators,dig the objective index of TCM clinical syndrome differentiation and treatment,and provide objective basis for TCM syndrome differentiation of EH with CAS.Methods: 251 patients diagnosed with EH combined with CAS in the one Hospital of Cardiovascular Medicine of Medicine from October 2021 to November 2022,According to the diagnostic criteria of traditional Chinese medicine syndrome,it is divided into inflammation on liver fire,phlegm dampness internal obstruction syndrome,internal obstruction of blood stasis,Yin deficiency Yang hyperactivity syndrome,kidney essence deficiency syndrome,qi and blood deficiency syndrome 6,Collect basic information of blood conventional neutrophils,absolute values of lymphocytes,biochemical indicators,ambulatory blood pressure and carotid color ultrasound,NLR calculated from data from routine blood tests,Correlations between TCM syndrome of EH combined with CAS and NLR,ambulatory blood pressure,and carotid plaque area were analyzed using SPSS 26.0 statistical software.Results: 1 A total of 251 EH patients with CAS were included in this study,Among them,184 patients with hypertensive grade 3,Cardiovascular risk stratification was very high-risk in 195 group,In 193 patients with carotid atherosclerosis with plaque formation,These three are the first proportion of each type;EH combined with CAS TCM syndrome type is divided into 6types,In 79 cases(31.50%),In 54 cases(21.50%),In 35 cases(13.90%),32cases(12.70%),In 29 cases(11.60%),22 cases(8.80%).2.Among the included EH patients with CAS,63.40% were female and 46.60% were male,and there was no statistical difference between men and women in each syndrome type(P>0.05).There was no significant difference in the distribution of smoking,alcohol consumption and ethnicity(P> 0.05).3.The age distribution of each syndrome type was significantly different(P <0.05),and the age was the oldest,which was statistically different from the inflammation,phlegm dampness internal obstruction and blood stasis(P<0.05).4.There was no significant difference in hypertension grade of each syndrome(P>0.05);cardiovascular risk stratification(P<0.05),the cardiovascular risk was high in that of renal sperm deficiency syndrome,and the difference was statistically significant(P<0.05).5.The distribution of plaque formation in carotid arteries of EH and CAS was significantly different(P<0.05).Carotid atherosclerosis were mainly hepatohepatic inflammation,and carotid plaques were mainly sputum and wet internal obstruction.6.The distribution of EH with CAS history was different,and patients with qi and blood deficiency had the highest proportion of cerebral infarction,and the lowest proportion of inflammation with cerebral infarction;the lowest proportion of arrhythmia.7.The levels of total cholesterol,LDL,and creatinine of EH patients with CAS were significantly(P <0.05).Comparing the biochemical indexes of each syndrome,the lowest levels,and the inflammation and blood deficiency were statistically significant(P <0.05);the highest differences between phlegm and dampness obstruction,stasis and blood obstruction,and qi and blood deficiency(P <0.05).8.EH patients with CAS were significant differences in NE,LY,and NLR(P=0.042,P=0.00 and P=0.00).The NE on liver heat inflammation was the lowest and different from renal essence deficiency and blood deficiency(P <0.05);the LY level was the highest,different from phlegm dampness internal obstruction,kidney essence deficiency and blood deficiency(P <0.05);the NLR was the highest and significant(P <0.05).9.Carotid artery plaque area was significantly different between the syndrome types(P=0.019),and the area of carotid plaque with deficiency of qi blood was the largest,which was statistically significant compared with the inflammation on liver fire,phlegm dampness internal obstruction,blood stasis internal obstruction,and Yin deficiency Yang hyperactivity syndrome(P <0.05).10.Results significant differences in the pulse pressure mean daily,early morning systolic pressure and early morning diastolic pressure(P=0.00,P=0.023 and P=0.019).Comparison of daily mean pulse pressure of each syndrome: kidney essence deficiency > Yin deficiency Yang > qi and blood deficiency > blood stasis internal obstruction > phlegm dampness internal obstruction > inflammation syndrome;kidney essence deficiency syndrome had the highest systolic pressure in the morning,compared with liver inflammation syndrome and qi and blood deficiency syndrome,the difference was statistically significant(P <0.05);the mean morning diastolic pressure was greater than inflammation syndrome,kidney essence deficiency syndrome,with statistical significance(P <0.05).Conclusion: 1.sputum dampness internal obstruction is the most common TCM syndrome of EH combined with CAS,and renal essence deficiency syndrome appears less.2.Carotid artery plaque area,average daily artery pulse pressure,and early morning blood pressure had some correlation with EH patients with CAS.The carotid artery plaque area was the largest,the daily average pulse pressure and early morning systolic blood pressure of renal essence deficiency,and the highest morning diastolic blood pressure of sputum and dampness internal obstruction.3.There is some correlation between NLR and the TCM syndrome type of EH patients with CAS,and the renal sperm deficiency syndrome has the highest NLR value and a high degree of inflammatory response.The status of inflammatory reaction is inferred clinically or through the TCM syndrome type of patients.4.NLR,carotid plaque area,Average pulse pressure throughout the day and early morning blood pressure can be used as objectified indicators of TCM syndrome differentiation in patients with EH with CAS. |
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